The insufficiency of medical material in health units constitutes a sign of the violation of Abuja Commitment and it denounces a certain weakness in the management of resources channeled for the “perfect” functioning of the National Health System (SNS).
The Observatório Cidadão para Saúde (OCS) identified the lack of medical material in Maputo and Pemba.
At José Macamo General Hospital, patients are forced to use the same medical material for two days. In the absence of elastic to locate the vein for blood withdrawal, health professionals use gloves.
“They give us gloves and ask us to keep them. For two or three days at least”, a patient told the OCS anonymously.
The source also said that she was obliged to keep the same material to ensure that the next day, they could use it.
Meanwhile, after the circulation of a communiqué announcing the lack of supplies, the OCS went after the patients to find out if it was true.
It is true, as patients are forced to make themselves to medical care with their own medical-surgical supplies, namely: two catheters; two syringes and four gloves.
Two ladies, residing in Pemba City, speaking to our team on the condition of anonymity, argument that they were severely beaten when they saw the communiqué related to the insufficiency of surgical-material.
“I had no money at all to buy my own gloves and syringes so that they could assist me in the childbirth service. I wasn’t even in a position to complain because of the pain”, recalls one of the ladies, without giving more details about the birthing process.
The second lady, using a shaky and hesitant voice, says that felt herself excluded, since she didn’t have the money to buy the needed material.
“I didn’t care about anything else but receiving medical assistance. I was in pain. I felt more pain when I learned that the hospital didn’t have enough material for the birthing service”, says the woman, adding that “I didn’t know what to do or think.”
How much does this cost for the simple user of National Health System?
“Internationally, it is recommended that gloves be changed for each procedure. It is recommended that each injectable medication has its own syringe. For example, if the medication is every six hours, that means you need four syringes per day. You can use one to two catheters per day, depending on its condition”, says a health professional, without identifying himself.
In the private pharmacy, one catheter costs 50 meticais (at the current exchange rate, 1 US dollar is equivalent to 63 meticais) and, per day, it may be necessary two for each patient treatment. The price of a pair of gloves for each surgical procedure varies between 25 and 50 meticais. The syringes that are needed for each medication range from 15 to 25 meticais. These prices exist in a country where the biggest part of the population lives on less than a dollar a day.
“Lack of basic surgical material shows of the violation of Abuja Commitment”
“The lack of basic surgical material is a manifestation of the violation of Abuja Commitment, in the sense of management of the resources channeled to the functioning of the SNS”, says the economist, stressing that “this problem has to do with the fragility of the management of the few resources that exist in our economy.”
The Abuja Commitment, signed by African countries in 2001, says that governments should allocate 15 percent of their budgets to the health sector. Mozambique, however, has never been able to achieve this percentage.
In addition to non-compliance with the commitment, the government has failed to invest about 146.81 billion meticais in the SNS over the last ten years, according to a study carried out by the Observatório Cidadão para Saúde (OCS).
The shortage of medical material, according to the economist, is an aggression to the citizen’s pocket, at a moment when the country is facing the third wave of the Covid-19 pandemic, characterized by high number of infections and deaths.
“After the Cyclone Idai and Kenneth, this situation constitutes an assault on the citizen’s pocket, at a time when the purchase of goods and services tends to worsen because of the Covid-19 pandemic”, Daniel says, stressing that “this situation represents a downfall for the Mozambican families.”
The economist also laments the fact that families have to worry about basic hospital materials, instead of “focusing on finding food for their survival.”
“It means that the government is mismanaging resources”
For Camila Fanheiro, a clinical psychologist associated with Saber Nascer – an organization that strives for obstetric humanization services – the lack of material in health units denounces the government’s weakness in the management of public resources.
“It means that the government is mismanaging resources, even though there are national and international partners that fund the NHS”, says Fanheiro.
In the wake of her argument, Saber Nascer representative also states that “We have already received information that, in certain health units, drugs after the deadline are being given to the patients.”
“It makes no sense to force the patients to bring their own supplies to the health facility. This represents an institutional violation. It also represents an obstetric violation, endangering pregnant women, women in berthing condition and postpartum condition”, she stresses.
Fanheiro – throughout her argumentation – defends the need to humanize the services carried out by the SNS, stressing the immediate rationalization of the distribution of resources in health units.
“Something must be done for the health sector. Last year, for example, I was forced to buy a bag urine for my father because the hospital didn’t have one. My father was almost forced to maintain his physiological needs in the plastic bag or gloves. This was a moral and psychological aggression to me”, Fanheiro laments.
For the Government to meet the minimum internationally acceptable conditions in the health sector, it would need to spend at least 113 billion meticais, corresponding to 32% of the total expenditure, three times what was spent in 2020.
On the other hand, Lia Viegas – also a clinical psychologist – believes that the lack of medical material in some health units denounces the stock deficit at the central level. It also denounces the pressure that the NHS has been suffering, since the attention is turned to Covid-19.
“This is a moment to ask for more help, instead of criticizing. At this moment, this rupture is normal”, Viegas says.
The OCS contacted two entities of the Provincial Hospital of Pemba management to question about the situation. However, the sources differ in their arguments, one refutes the existence of the communiqué and the other confirms its existence, refusing, however, to go into details about the insufficiency of supplies in that hospital.